Silver Economy Netherlands Telehealth Chronic Illness


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Silver Economy Netherlands Telehealth Chronic Illness

  1. 1. Caring for People with Chronic Illness: The Role of Telehealth Technology Steve Brown CEO, Health Hero Network 29 November 2006
  2. 2. Our Shared Vision <ul><li>A better model of care serving people who struggle with chronic conditions. </li></ul>
  3. 3. What the world is thinking about right now:
  4. 4. What the world is thinking about right now:
  5. 5. What the world is thinking about right now:
  6. 6. What the world is thinking about right now:
  7. 7. What the world is thinking about right now:
  8. 8. What do we want?
  9. 9. What’s Telehealth Got To Do With It? <ul><li>A Better Model of Care </li></ul><ul><li>= </li></ul><ul><li>Change Behavior and </li></ul><ul><li>Moving Care to the Home </li></ul>
  10. 10. How to Change Behavior and Move Care to the Home <ul><li>Personal Coaches for Everyone? </li></ul><ul><li>Nurses with Phones? </li></ul><ul><li>Nurses with Cars? </li></ul><ul><li>Doctors with Phones and Cars? </li></ul><ul><li>Remote Health Management Technology! </li></ul><ul><li>What Gets Measured Gets Done! </li></ul>
  11. 11. The Market Has Arrived “ Mr. Bohana, an 82-year-old World War II veteran, has been able to move from living in hospice under round-the-clock medical supervision to a Brooklyn studio apartment with the help of a relatively simple monitoring system from Health Hero Network. The hand-held Health Buddy console, which plugs into his phone, delivers his blood pressure and weight readings to a Veterans Affairs nurse. It also prompts him to answer a series of qualitative questions about his lung and circulatory ailments, like whether his breathing is better or worse than the day before. “ This is so simple a 2-year-old could do it,” Mr. Bohana said.”
  12. 12. Success Story: Veterans Administration <ul><li>Today </li></ul><ul><li>16,000+ patients enrolled in daily home telehealth with Health Buddy </li></ul><ul><li>Deployed in 120+ clinical sites </li></ul><ul><li>Over 100 programs for 30+ chronic conditions </li></ul>February 2006
  13. 13. Care Management Process with the Health Buddy System Education, monitoring and feedback at home Personalized, remote care management and support. Scripted messaging, monitoring and reporting platform
  14. 14. Technology Enabled Model of Care <ul><li>The Health Buddy System </li></ul>Patient Centric Technology Enabled Provider Directed
  15. 15. Expanding the Reach of the Health Buddy System <ul><li>The Next Step: </li></ul><ul><li>Platform Independent Content Delivery Solutions </li></ul>
  16. 16. Health Buddy Teleguidance <ul><li>Delivery of Health Buddy Program content through the television with IPTV </li></ul><ul><li>Pilot Program </li></ul><ul><ul><li>Available for Meavita customers in the Netherlands </li></ul></ul><ul><ul><li>Initial program for diabetes patients </li></ul></ul><ul><ul><li>Health Buddy Teleguidance will Launch in 2007 </li></ul></ul>Health Buddy Teleguidance Project Contributors: Health Hero Network Meavita Sananet B.V. Impact Media
  17. 17. Care Management Process: Technology-enabled, Provider-directed Model <ul><li>Keeps care provider “in touch” with patient </li></ul><ul><ul><li>Monitor patient daily </li></ul></ul><ul><ul><li>Assess patient risk </li></ul></ul><ul><ul><li>Identify change in patient’s health </li></ul></ul><ul><ul><li>Intervene before crisis occurs </li></ul></ul><ul><li>Improves productivity </li></ul><ul><li>EMR Integration </li></ul><ul><li>Secure web application </li></ul>Health Buddy Desktop
  18. 18. Health Buddy Desktop: Tools to Enable Management by Exception
  19. 19. Health Buddy Programs <ul><li>Library of 100+ programs </li></ul><ul><li>Over 30 health conditions </li></ul><ul><li>English & Spanish </li></ul><ul><li>Ready to deploy </li></ul><ul><li>Customizable </li></ul><ul><ul><li>Evidence based practice guidelines </li></ul></ul><ul><ul><li>Patient education </li></ul></ul><ul><ul><li>Care management </li></ul></ul><ul><li>Hyperlipidemia </li></ul><ul><li>Hypertension 1 </li></ul><ul><li>Med. Compliance </li></ul><ul><li>Myocardial Infarc. </li></ul><ul><li>Pain Mgt 2 </li></ul><ul><li>Pediatric Asthma 2 </li></ul><ul><li>Polypharmacy </li></ul><ul><li>PTSD </li></ul><ul><li>Pre-Diabetes </li></ul><ul><li>Schizophrenia </li></ul><ul><li>Sr. Wellness </li></ul><ul><li>Substance Abuse </li></ul><ul><li>Smoking Cessation </li></ul><ul><li>Spinal Cord Injury </li></ul><ul><li>Weight Mgt </li></ul><ul><li>Adult Asthma 2 </li></ul><ul><li>Advanced Illness / </li></ul><ul><li>Palliative Care </li></ul><ul><li>Anticoagulation </li></ul><ul><li>Bipolar Disorder </li></ul><ul><li>Cancer 2 </li></ul><ul><li>Caregiver </li></ul><ul><li>COPD 1 </li></ul><ul><li>Coronary Artery 2 </li></ul><ul><li>Cystic Fibrosis </li></ul><ul><li>Depression 2 </li></ul><ul><li>Diabetes 1 </li></ul><ul><li>Functional ADLs </li></ul><ul><li>Heart Failure 1 </li></ul><ul><li>Hepatitis C </li></ul><ul><li>HIV </li></ul>
  20. 20. Care Management Process: Personalized Coaching and Monitoring <ul><li>Dynamic branching logic collects information on: </li></ul><ul><ul><li>Symptoms </li></ul></ul><ul><ul><li>Behavior </li></ul></ul><ul><ul><li>Knowledge </li></ul></ul><ul><li>Delivers unique reply to each patient response in the form of </li></ul><ul><ul><li>Call to action </li></ul></ul><ul><ul><li>Information / education </li></ul></ul><ul><ul><li>Further assessment </li></ul></ul><ul><ul><li>Reinforcement / reminder </li></ul></ul><ul><ul><li>Acknowledgement </li></ul></ul>
  21. 21. Care Management Process: Creating Feedback Loops H M L K nowledge B ehavior S ymptoms Stabilize Patients Over Time <ul><li>Identify high risks & potential problems </li></ul><ul><li>Address needs through dynamic content </li></ul><ul><li>Move risks to lower levels </li></ul><ul><li>Stabilize health status </li></ul><ul><li>Identify changes in status early on </li></ul><ul><li>Manage by exception </li></ul>H M L K nowledge B ehavior S ymptoms H M L K nowledge B ehavior S ymptoms
  22. 22. VA Outcomes 2002: Telehealth Reduces Inpatient Utilization* <ul><li>40% reduction in ER visits </li></ul><ul><li>63% reduction in hospital admissions </li></ul><ul><li>63% reduction in hospital bed days of care </li></ul><ul><li>64% reduction in nursing home admissions </li></ul><ul><li>88% reduction in nursing home bed days </li></ul><ul><li>Significantly improved Quality of Life SF36V </li></ul>1-Year Telemedicine Care Coordination Demonstration * Published in Disease Management Volume 5, Number 2, 2002.
  23. 23. VA Outcomes 2005: Telehealth Improves Clinical Outcomes* <ul><li>Hospitalizations declined from 630 inpatient days pre to 122 during intervention period </li></ul><ul><li>Bed Days Of Care fell from 8.63 to 1.65 (p < 0.001) </li></ul><ul><li>Blood Pressure: 129/73 to 119/69 (p < 0.05) </li></ul><ul><li>Weight: 196 to 192 (p < 0.01) </li></ul><ul><li>Shortness of Breath 0-10 Scale: 4.0 to 2.7 (p = 0.02) </li></ul><ul><li>ACE Inhibitor Avg Daily Dose: 24mg/d to 35 (p < 0.01) </li></ul><ul><li> -Blocker Avg Daily Dose: 84 mg/d to 94 (p = 0.05 ) </li></ul>1-Year Telemedicine Care Coordination Demonstration * Published in Telemedicine and e-Health Volume 11, Number 1, 2005.
  24. 24. SPAN-CHF II Study 2005: Telehealth Reduces Hospital Readmissions* * Presented at American Heart Association Annual Meeting, Scientific Sessions, 2005. 72% Reduction (p=0.03) 63% Reduction (p=0.029) Heart Failure Re-Hospitalizations All Cardiac Hospitalizations Health Buddy Control Health Buddy Hospitalizations PPPY Control 3-Month CHF Study
  25. 25. Mercy Study: Compliance Drives Outcomes Medication Compliance as Measured by Pharmacy Claims and Patient Self-reporting $25,013 $11,854 Hospitalization Costs for CHF patients decreased 52% PPPY Health Buddy Before Health Buddy Standard 1-Year Diabetes & HF Study
  26. 26. Patient Acceptance <ul><li>95% patient satisfaction 2 </li></ul><ul><li>86% better understand their treatment and are better able to manage their health condition </li></ul><ul><li>Patients feel more connected to their care provider 2 </li></ul>Patients enjoy significant improvements in quality of life 1 1 Diabetes Technology & Therapeutics, Volume 4, Number 6, 2002. 2. Henry Ford Medical Center, CAD Study, 2004. (n=602)
  27. 27. The People We Serve <ul><li>“ Health Buddy is the best thing to come down the pike. When I get up in the morning, I feel confident I am good for another day.” </li></ul>Wally Browning 1941-2006
  28. 28. Contact Information: Steve Brown, CEO Health Hero Network, Inc. 2000 Seaport Blvd. Fourth Floor Redwood City, CA 94063 [email_address] 650-779-9101